Adrenal Fatigue

Chronic stress is associated with a lot of health problems because of the constant high levels of Cortisol secreted. As a result the body is constantly in a state of readiness for a possible “danger” that may strike. Chronic stress may cause various effects.

Frequently Asked Questions

  • 1What is Adrenal fatigue, also known as Adrenal stress syndrome / Stress Management / Burn out?
  • 2What are the common symptoms of adrenal fatigue / chronic stress?
  • 3How does chronic stress lead to "burn out"?
  • 4How is Adrenal Fatigue /Adrenal Stress Syndrome managed by MAINSTREAM medicine?
  • 5How important is it to address biochemical abnormalities in adrenal fatigue ?
  • 6How is Adrenal Fatigue / Adrenal Stress Syndrome managed at Health Renewal?
  • 7What are the signs that you may be suffering the effects of Chronic Stress?
  • 8Why is it important to recognize the symptoms of adrenal fatigue / burnout?
  • 9What are the DEADLY Consequences of Chronic Stress?
  • 10What adverse effects can chronic physical or psychological stress have on the body?
  • 11How does the body respond to stress?
  • 12What function does Cortisol have?
  • 13How is cortisol secreted and what is its function?
  • 14How does one recognize when Stress is getting the best of you?
  • 15What therapies and nutraceuticals can improve Adrenal Fatigue?
  • 16Health Renewal tip: What lifestyle strategies are there for overcoming chronic stress?
  • 17Why should one not self-medicate?
  • 18How do I get started?
  • 19How do we treat this at Health Renewal?
  • 20What should you bring along to your appointment with your Health Renewal doctor?
  • 21What is the cost of the extended consultation with the Health Renewal doctor?
  • 22Health Renewal tip:
  • 23Health Renewal's 10 Inspiring Quotes For Healthy Living:

Adrenal Fatigue has a broad spectrum of non-specific, yet often reflecting symptoms. Reports by the American Academy of Family Practice and the Russian Department of Family Care, state that nearly 66% of patients coming to Doctor’s offices have conditions related to stress. Yet, despite its connection to illness, a study in an America survey revealed that 33 percent of Americans never discuss ways to manage stress with their healthcare provider There is often a slow and sneaky onset of stress related conditions. Once a patient has a consult with a Doctor and stress is identified as the cause they are advised to relax and stress less. But just how do we go about doing this?

Chronic stress is associated with a lot of health problems because of the constant high levels of Cortisol secreted. As a result the body is constantly in a state of readiness for a possible “danger” that may strike. Chronic stress may cause various effects. To name a few these can include:

Fatigue, lethargy, tiredness, feeling worn out and experiencing fearfulness. Chronic allergies, frequent influenza and arthritis. Anxiety, depression, difficulties in concentrating, sleeping problems/ insomnia. Digestive problems, memory loss, sexual dysfunction, heart disease, and thyroid abnormalities. Additionally there can be abnormalities of our sex hormones, the inability to lose weight after extensive effort, obesity due to hormones involved in digestion, weight, metabolism and blood glucose control being affected by stress. Obesity is a predecessor to the development of chronic diseases, like Diabetes.

It is important to have some background information on this condition:

Our bodies are designed to handle possible dangers, such as an imminent threat to your safety, which we call the “fight or flight” mechanism. This mechanism makes it possible for our bodies to respond to threats by either “fighting” against, of “fleeing” from the situations. In a dangerous situation your heart rate increases and so does your blood pressure, this allows your body send additional resources to your muscles and respond accordingly. The downside is that whilst your body is in this heightened mode it suppresses other non-essential bodily functions, which includes digestion, general immune system health and the reproductive system.

Our bodies are designed to cope with these changes in the situation when it is needed, but if this is a constant situation our bodies’ health can be negatively affected. When an individual experiences chronic stress, it will cause the body to be in a constant “fight or flight” mode, thereby causing a continuously high level of Cortisol in our body. Cortisol is commonly known as the stress hormone. Cortisol levels that are constantly high can have harmful effects on the body.

Over a prolonged timeframe of high Cortisol levels due to the body being in a state of “fight or flight”, the body can experience damaging symptoms such as high blood pressure & Insulin resistance. Elevated blood pressure along with deteriorating insulin sensitivity, are both contributing factors (as well as several other stress-related physiologic irregularities), to a compromised health state. Eventually this can predispose individuals to the onslaught of age-related diseases.

Conventional medicine often relies upon psychoactive drugs (such as antidepressants, anti-psychotics, and anti anxiety drugs) to mask a stressed patients’ symptoms. Emerging research is suggesting that there are certain psychoactive drugs (like those used to treat anxiety and depression), that may stabilize mood. This happens by acting upon neurotransmitter levels, but also by modulating the action of glucocorticoids receptors within the brain. Due to these finding it is interesting to note that in supporting mood elevation it is important to control stress factors when treating a patient.

Mainstream stress management strategies often fail to address biochemical abnormalities, of which an imbalanced adrenal hormone level can be one. Leaving this imbalance within the body can contribute to detrimental health effects caused by continuous stress.

In todays’ stressful world it is vitally important to maintain a balanced lifestyle through a multimodal approach. This includes following a healthy eating plan, making sure you get plenty of exercise and making use of innovative natural ingredients to support the body’s natural adaptive abilities.

By having regular blood tests done AM & PM Cortisol levels and also DHEA levels it can help maintain balanced stress hormone levels.

Additional blood test of Cortisol, 24Hour (urine test), doing a Female/Male Comprehensive Hormone and Panel and / Dehydroepiandrosterone Sulfate (DHEA-S), may prove helpful in monitoring and maintaining balances stress hormone levels.

Adrenal Fatigue is a very complex disorder, and therefore each patient’s unique clinical history & physical examination will determine on what, and how the treatment plan will be built. After having read this discussion and learning more you will appreciate the danger that chronic stress holds, what diseases it can cause later in life, and also know how you can optimize your stress response by combining healthy lifestyle habits with scientifically studied natural therapies.

The most important component is to IDENTIFY the symptoms of Adrenal Fatigue and to seek help for this condition. ( Please see the next question.)

  • Excessive fatigue after minimal exertion; feeling “overwhelmed” by relatively trivial problems
  • Trouble awakening in the morning, even after adequate sleep
  • Relying on coffee (caffeine) and other “energy” drinks for a pick me up
  • Perceived energy burst after 6:00 PM
  • Chronic low blood pressure
  • Hypersensitivity to cold temperatures
  • Increased premenstrual symptoms (PMS) symptoms
  • Depression and/or labile mood swings
  • Mental “fog” and poor memory
  • Decreased sex drive
  • Anxiety
  • Craving sugar and salty foods, or a Decreased appetite
  • Imbalanced immune system
  • Chronic allergies
  • Generalized weakness and dizziness upon standing
  • It is very important to rule out other possible causes before attributing symptoms to chronic stress alone.

Adrenal Fatigue, or stress syndrome, is a condition that causes many secondary health problems. However if one can identify this early enough, these conditions might be prevented.

At Health Renewal we are able to do very specific saliva tests, or blood tests, though which we can see exactly what the Cortisol/DHEA levels, and associate hormone levels in the body are. This can then be rectified with the correct Bio-identical hormone replacement, DHEA RESTORATION & high-quality neutraceuticals, as well as the necessary lifestyle changes. See Health Renewal Tip at the end of this discussion.

1. Stress cardiomyopathy, is a spontaneous weakening of the heart which predisposes victims to arrhythmia, and even sudden cardiac death. This process is not yet clearly understood, but it is thought that chronic stress-induced elevations in adrenaline over-stimulate the cardiac muscle, altering its function and causing atrial remodelling .

2. Karoshi, this condition was recognized in post-World War II, in Japan. It occurred in overworked and severely emotionally and physically stressed Japanese high level executives who suffered strokes and heart attacks at alarming rates at relatively young ages. Researchers discovered that the death of these otherwise healthy men was due to chronic, unremitting stress.

3. Atherosclerosis progression. Prolonged stress has been linked with elevated circulating markers of inflammation, and increased intima media thickness, a measure of atherosclerosis progression.

4. Chronic stress can contribute considerably to the risk of anxiety and depression by causing structural and functional changes in the brain.

5. Moreover, those who do not properly manage and adapt to chronic stress are more likely to be overweight and develop sexual dysfunction.

  • Increase our risk of a high blood pressure and heart problems
  • Dementia
  • Depression
  • It can also increases our risk for some types of cancer

When an individual experiences a stressor, be it physical or emotional, internal or environmental, the body initiates a complex system of adaptive reactions to help cope with the stress. This is a reactive response which results in the release of glucocorticoids (also known as stress hormones), and catecholamines, which stimulate adaptive changes in a variety of bodily systems.

Cortisol is, in many ways, a paradoxical hormone and needs to be in balance for optimal bodily functioning. The body requires a certain amount of cortisol for optimal health, but too much or too little can be unhealthy.

Cortisol has the function of regulation of blood glucose levels by a process called gluconeogenesis in the liver. It also regulates the immune system; in additional to regulating of carbohydrate, protein and lipid metabolism. Cortisol is regarded as an anti-inflammatory hormone, a blood glucose modulator, an immune-modifier and adaptation hormone.

Depending on a person’s diet, exercise levels, stress, and time of day, serum levels of cortisol can vary. During healthy conditions, a person’s cortisol levels peak in the early morning hours (usually around 8AM) and dip to their lowest between midnight and 4AM. However, when a patient suffers from chronic psychological stress, for example, the adrenal glands excrete an abnormal amount of cortisol in an abnormal rhythm, leaving the body out of sync.

Cortisol, being a catabolic hormone (indicating that it breaks down tissues), when out of balance and unregulated, can have detrimental effects on body composition. To make matters worse, too much cortisol can suppress the immune system, while too little can lead to autoimmunity and rheumatologic disorders.

Everyone is designed with an inborn ability to handle stress. However, not everyone has the same tolerance levels : some can only cope with low levels and short durations of stress, while others adapt and can accommodate higher levels stress for more prolonged periods.

In 1935, Dr. Hans Selye devised the term stress as a factor that induced behavioural changes in mammals. He then extended this statement to include higher level organisms (i.e. humans) as also being effected by stress in a harmful way.

According to Dr. Selye, there are three states the body faces when dealing with stress.

1) First there is the “Alarm state”: where the body has to adapt to acute stress; this is where the “fight-or-flight” response kicks in.

2) Second is the “Resistance state”: this occurs when there is an emergence of consequences of prolonged stress response activation (i.e. insulin resistance).

3) The Third state is the “Exhaustion state”: here there is a decline in responsiveness and sensitivity of primary relays of the HPA axis (i.e. hypothalamic deterioration / dysfunction leading to erratic or insufficient stress hormone and catecholamine production and subsequent mood disorders and fatigue).These same imbalances in the HPA axis and stress response mechanisms that contribute to these signs and symptoms also contribute to the deadly sequel of more serious stress-related illness.

It becomes clear why you have to recognize that you are experiencing some, or all, of the symptoms as an important initial step towards achieving better overall health and mitigating your risk for various diseases.

1. Hormonal Therapies DHEA: for women (depending on blood test results) and men (depending on blood test results). Melatonin: before bed Bioidentical Hormone Replacement Therapy: Refer to Male Hormone Restoration protocol, or Female Hormone Restoration protocol.

2. Nutritional Therapies B-Complex vitamin: Thiamine (B1), Riboflavin (B2), Niacin (B3). Folate (preferably as L-methylfolate); Vitamin B12; Biotin; Pantothenic acid; Vitamin C; Fish oil (with olive polyphenols); Phosphatidylserine L-Theanine; Calcium; Magnesium; Zinc; Chromium; Selenium; Manganese; Comprehensive multivitamin formula.

3. Herbal Therapies Lemon Balm extract, Valerian root, and Licorice Root.

4. Adaptogens Rhodiola rosea; in its standardized extract. Ginseng (Panax), Ashwagandha, in its standardized extract. Standardized blend of bacopa, ashwagandha, and cordyceps extracts. Holy basil

Dr. Thierry Hertoghe, who is an internationally noted endocrinologist, advises a few lifestyle modifications to consider, implement and adhere to before consideration of natural or pharmacological therapies. Lifestyle modifications alone for patients with mild to moderate forms of impaired stress response may alleviate the symptoms. Dietary supplements and/or hormone therapy can complement lifestyle modification to resolve adrenal dysfunction.

1. The obvious recommendation of avoiding stressful situations and occurrences is the first path of action:

  • Set limits: Setting limits on non-essential obligations is important to mitigating chronic stress. List all of the projects and commitments that are making you feel overwhelmed. Identify those tasks you feel you absolutely must do in order to survive, and cut back on anything non-essential. For projects that are work-related, discuss a list of your responsibilities with your supervisor and get his or her input on priorities and how best to tackle the projects at hand. For commitments that are social or non-work related, such as community or volunteer activities, consider contacting the people you’ve made these commitments to and letting them know that you cannot meet those obligations at this time. You also may ask for assistance in getting these tasks accomplished. Refrain from accepting any more commitments until you feel your stress is under control.
  • Commuter stress, for example, can affect your body. As a solution look at moving to a home closer to your workplace or finding a job closer to home is an obvious solution.

2. With regard to the diurnal biorhythms of cortisol release, a few things increase cortisol at the inappropriate time.

  • The consumption of alcohol and caffeinated beverages such as tea and coffee before bedtime or late at night, is not recommended as caffeine can increase serum cortisol levels, and this is counterproductive during the evening hours when the normal trough is expected. Additionally, caffeine and alcohol affect the release of melatonin (melatonin counters some of the negative effects of cortisol), causing a relative reduction in melatonin secretion during the night when a spike is usually experienced.
  • If working third-shift causes disruption in your cortisol levels or circadian rhythm resulting in disease, then change your work schedule to eliminate this stressor

3. Tap into your support system.

  • Reach out to a friend and/or relative with whom you’ve enjoyed a close relationship over the years. Let them know you are having a tough time and welcome their support and guidance; a shared burden is always lighter. Your friend or relative may have tackled similar challenges and have useful ideas and perspectives. There is no need to face challenging life circumstances alone. In fact, support from family or friends may help you start and sustain taking better care of yourself.

4. Make one health-related commitment.

  • Do what is possible to bolster your health so that you have the energy and strength to tackle the challenges you are facing. One small step, like cutting back on your caffeine consumption, can have a positive effect. Studies show that without caffeine, people reported feeling more relaxed, less jittery or nervous, slept better, had more energy and experienced less heartburn and fewer muscle aches.
  • Similarly, a brisk walk or other aerobic activity can increase your energy and concentration levels and lessen feelings of anxiety. Physical activity increases your body’s production of good-feeling endorphins, a type of neurotransmitter in the brain, and decreases the production of stress hormones. Taking positive steps for your health will help you manage your stress.
  • Smoking and extremely vigorous or protracted bouts of exhaustive exercise impact the adrenals in a negative way as well.

5. Enhance your sleep quality.

  • People who are chronically stressed often suffer from lack of adequate sleep and, in some cases, stress-induced insomnia. According to an America survey, 47 percent of all adults say they lie awake at night because of stress. It is important to take steps to increase the quality of your sleep
  • Experts recommend going to bed at a regular time each night, striving for at least 7-8 hours of sleep, and if possible
  • Eliminate distractions, such as television and computers from your bedroom. Begin winding down an hour or two before you go to sleep and engage in calming activities such as listening to relaxing music, reading an enjoyable book, taking a soothing bath or practicing relaxation techniques like meditation
  • Avoid eating a heavy meal or engaging in intense exercise immediately before bedtime
  • If you tend to lie in bed and worry, write down your concerns well in advance of bedtime and then work on quieting your thoughts before lights-out. You can figure out how to address stressful issues in the morning, after a good night’s sleep.

6. Strive for a positive outlook.

  • Looking at situations more positively, seeing problems as opportunities and refuting negative thoughts are all important aspects of staying positive and trying to minimize your stress. In some people, stress can be caused by their attempts to handle things perfectly. Setting more realistic expectations and positively reframing the way you look at stressful situations can make life more manageable. Also, difficult circumstances have a way of working out; it is important to keep challenges in perspective and do what you can reasonably do to move forward.

7. Seek additional help.

  • If you continue to feel overwhelmed, are feeling hopeless or are having trouble getting through your daily routine, seek consultation with a licensed mental health professional such as a psychologist. Psychologists are trained to help you develop strategies to manage stress effectively and make behavioral changes to help improve your overall health

8. Other therapies

  • Such as acupuncture, Traditional Chinese Ping, Ayurvedic medicine, massage therapy, relaxation, yoga and even music therapy have shown success in stress management and potential avenues to explore.

9. Owning a pet

  • This is associated with improved physical and psychological health. For chronically stressed individuals, adopting a dog or cat may help ameliorate some of the symptoms and effects of chronic stress

For all health conditions, the nutraceuticals are individually tailored by the Health Renewal Doctor. The doctor will decide- based on your history, physical examination and blood tests what would be the best for you and your specific needs and/or deficiencies. It cannot be overemphasized that one must not self-medicate. Self-Medicating is done when a person takes prescription medication or nutraceuticals on their own without a doctor's supervision and/or consent. By not having a physical examination and blood testing done by a qualified and practising integrative medical practitioner, you could be not treating vital deficiencies or conditions such as elevated blood pressure, high sugar level, high stress levels (that can lead to adrenal burnout ) and high blood clotting factors that could lead to heart attacks and stroke. In addition, aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. There is no single supplement prescribed to clients as there is no magic bullet that can support all the essential nutrients that one's body needs. Today's food is not functional and we need to supplement in order to maintain optimal bodily functions and nutrition.

Make an appointment to consult with your Health Renewal Doctor who is an integrative doctor and he / she will assist you in determining your risk factors and how best to prevent any problems or conditions that you may be susceptible to.

The initial medical consultation at Health Renewal will be approximately 45 minutes. As this is a prolonged medical consultation, the initial consultation fee will be R 975 on arrival (for non loyalty programme members) you will have to complete an in depth questionnaire before the consultation so please arrive 20 minutes before the time. During the 45 minute consultation your Health Renewal doctor will obtain a FULL medical history from you to determine your personal risk. A physical examination will be done after which the Doctor will decide which blood tests need to be requested from your local pathology laboratory. If you have a medical aid, these should be able to be claimed as well.

Once your blood results are received, they will then be analysed by your Health Renewal doctor who will begin working on a unique prescription plan for you with the compounding pharmacy. At your pre-scheduled second appointment 2 weeks later, the results and examination findings will be discussed with you. This will determine what abnormalities or deficiencies exist and you will be advised on your treatment options. These options may range from prescription medications, nutraceuticals, bio-identical hormonal creams / tablets or alternatively to having bio-identical implants / pellets inserted.

In office treatments such as Carboxytherapy may also be recommended for certain conditions such as hair loss, erectile dysfunction ED, menopause or PMS. If you need to lose weight our Body Renewal Medical Weight loss program may be recommended. All these recommendations will be summarised on a sheet / print out which you can take home with you. The nutraceuticals offered at Health Renewal are of superior quality (Solgar) and are not rancid nor contain Hg( mercury ) or PCB'S (which is very important for Omega 3 Essential fatty acids EFA's). They are also free of gluten, preservatives, wheat, dairy, soy, yeast, sugar, artificial flavors, sweetener and colour. We have a great professional team made up of doctors, trained and registered nurses and therapists to support you at any time.

1. You are kindly requested to bring any supplements that you are currently taking, along to your consultation. The doctor can check the ingredients in take this into account when prescribing a treatment plan for you.

2. Also, if you have had any blood work done in the past 6 months, please bring the results along to the consultation. Should you not be in possession of the hard copies, please request these results from the lab you visited. Usually your ID number is sufficient.

Depending on the exact prescription given, you may be required to return to the doctor within 1-4 months’ time, in order to ensure optimum hormone levels are achieved. This will be determined by a repeat blood test and may be requested by your Health Renewal doctor.

You should ensure that you are current with your gynaecological visits/breast exams/mammograms (for female patients) and prostate exams (for male patients) as recommended by your GP/gynaecologist.

Fees:

  • The fee for the initial consultation and evaluation of 45 minutes is R975. A deposit of R400 is required up front in order to secure your consultation with the doctor. This advance payment goes towards your consultation fee. Proof of payment needs to be received one week in advance of appointment email. Please see banking and contact details below. This consultation fee may be claimed back from your medical aid depending on which kind of medical over you have.
  • A second follow up consultation is essential in order for the doctor to assess your blood work and prescribe a personalised treatment plan for you. Another deposit of R400 will be required to secure the second consultation.
  • All subsequent follow up consultations with the doctor will be charged at R650 for 30 minute consultations. This may be amended from time to time at the practice’s discretion.
  • You may pay for your consultation by cash, credit card or EFT.
  • BIHRT prescriptions must be paid for prior to ordering, as each patient’s prescription is unique to his/her own needs, and you will receive an invoice advising you of the cost.
  • The patient is responsible for paying all consultation and prescription fees to Skin, Body and Health Renewal – regrettably we do not accept medical aid.
  • An added bonus is that not only improving your health and well being , any nutraceuticals purchased will go towards loyalty points at any Skin, Body and Health Renewal branches.

The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments , nutritional supplements and a healthy diet and lifestyle.

Here are ten quotes from great thinkers to challenge, motivate and inspire us to exercise, eat right and live healthier lives:

  • "Health and intellect are the two blessings of life." - Menander (ca. 342–291 BC) – Greek dramatist.
  • “Let food be thy medicine and medicine be thy food” ― Hippocrates
  • “A fit, healthy body—that is the best fashion statement” ― Jess C. Scott
  • “Healthy citizens are the greatest asset any country can have.” ― Winston Churchill
  • “A fit, healthy body—that is the best fashion statement” ― Jess C. Scott
  • “You are not a mistake. You are not a problem to be solved. But you won't discover this until you are willing to stop banging your head against the wall of shaming and caging and fearing yourself." ― Geneen Roth, Women Food and God: An Unexpected Path to Almost Everything
  • “I promise you nothing is as chaotic as it seems. Nothing is worth your health. Nothing is worth poisoning yourself into stress, anxiety, and fear.” ― Steve Maraboli, Unapologetically You: Reflections on Life and the Human Experience
  • “Money cannot buy health, but I'd settle for a diamond-studded wheelchair.” ― Dorothy Parker
  • “I run because if I didn’t, I’d be sluggish and glum and spend too much time on the couch. I run to breathe the fresh air. I run to explore. I run to escape the ordinary. I run…to savor the trip along the way. Life becomes a little more vibrant, a little more intense. I like that.” ― Dean Karnazes, Ultramarathon Man: Confessions of an All-Night Runner
  • “When health is absent, wisdom cannot reveal itself, art cannot manifest, strength cannot fight, wealth becomes useless, and intelligence cannot be applied.” ― Herophilus
  • “If we are creating ourselves all the time, then it is never too late to begin creating the bodies we want instead of the ones we mistakenly assume we are stuck with.” ― Deepak Chopra

Reviews

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*Please note results may vary by individuals.
Review -I feel like a human again!
Reviewed on 12 February 2016 by A.C from Fourways *

Dr Maurits Kruger have been treating me and diagnosed me with Adrenal Fatigue. After only 2 weeks of treatment I feel like a human again. Dr Maurits is a fantastic doctor. He is so patient and kind hearted. He does really care.

Read more
Review -After IV treatments, all my symptoms have improved!
Reviewed on 14 May 2014 by Vanessa Welke*

I am a project manager who suffered “burn-out” after managing the new extension to a casino. “I was taking Glucophage (diabetes medication) because I was heading towards Type II diabetes. Dr Jooste sent me for blood tests, and formulated a cocktail of vitamins and supplements. I did a course of IV treatments, twice a week, and in April and May, I had only three IV treatments. I no longer have to take insulin and everything has improved. My hormones are stable, my skin texture is great and I sleep very well for a change.”

Read more